The present invention relates to the computerized financial transactions art. It finds particular application in conjunction with reimbursements made for physician's services and the processing of medical insurance claims.
Heretofore, it has been necessary for physicians to process a wide variety of papers and forms to receive compensation for their services. The numerous insurance companies which have provided medical insurance to the consuming public have had a wide range of different forms which must be submitted to receive compensation. Some of the forms were to be submitted by the doctors and others were to be submitted by the patients. Under some insurance policies, the patient has been a co-insurer who was responsible for a portion of the medical bills. In other instances, the physican's fees have exceeded the compensation paid by the insurance company, leaving a balance to be paid by the patient. Some insurance companies have paid the benefits directly to the patient and the patient has reimbursed the doctor; whereas, other insurers have paid the doctor directly. Even as to monies paid by the patient, some patients paid by check or cash at the time the services were rendered, some paid by credit card, and others were invoiced. The processing of the numerous different types of insurance forms and modes of payment has created a major paper processing problem. Many physicians and clinics have had to hire extra staff whose sole job function was to handle this paperwork. The extra staff increased over head which was passed on to the consumer in the form of higher medical bills.
Even once the forms were filled out and submitted, the physician still faced the problem of collecting the amounts invoiced to the insurance companies and patients. Forms which were filled out improperly were commonly returned to the physican to be processed again. Even forms that were properly filled out commonly required extended durations for processing by the insurance companies before reimbursement checks were mailed. In some instances, the processing time was several months. If the claim exceeded the limits of the insured policies, the same processing time elapsed before the physician was advised that he was receiving only partial payment. Partial payments by the insurance companies necessitated invoicing the patients, possibly months after the services were provided. These delays between the time the services were provided and when compensation was received again increased the physician's overhead. This increase in overhead again resulted in higher medical costs to the consumer.
The present invention provides a new and improved computerized financial transaction system for physicans and other medical personnel which overcomes the above referenced problems and others.